Article

Insuring the Future

Congress Should Reauthorize and Expand the State Children’s Health Insurance Program

Reauthorizing and strengthening SCHIP is necessary for guaranteeing affordable coverage, and key to moving forward with heath care reform.

Nearly 47 million Americans have no health insurance. That’s about 16 percent of our population, including nine million children. Today the Senate Finance Committee will consider the future of the State Children’s Health Insurance Program, one of the signature public programs that provide coverage to millions of low-income kids and keeps this problem from growing even faster.

Congress established SCHIP in 1997 to provide coverage to uninsured, low-income children whose families do not qualify for Medicaid coverage. The program allows states to extend health care coverage to low-income children up to 19 years of age; most states provide coverage to children living in families with incomes at or above 200 percent of the federal poverty level, while some restrict eligibility to children living in somewhat poorer families. During 2005, SCHIP provided health insurance to 6.1 million children, and currently enrolls 68 percent of eligible children, although participation rates vary by state.

SCHIP, in combination with Medicaid, has ensured that children who have lost employer-based coverage over the last 10 years have largely been able to remain insured. In contrast, the number of uninsured adults has grown by nearly 6 million.

Federal funding is set to expire this year unless Congress reauthorizes the program. While the SCHIP program enjoys broad support, Congressional reauthorization will be complicated by budget issues. The current budget projections assume that the program will continue to be funded at the 2007 level—even though health care costs grow every year. Some experts estimate that this freeze in funding will result in a federal funding shortfall of $14.6 billion over five years, imperiling health coverage for nearly 2 million children.

Reauthorizing and strengthening SCHIP is a necessary step to guaranteeing affordable health coverage for all Americans. Without the firm foundation of the Medicaid and SCHIP programs, it will be immeasurably more difficult to proceed with real health system reform. Federal policymakers should ensure that a reinvigorated SCHIP program continues to provide critical health insurance coverage to our nation’s children.

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